Prevalence of disability in Morocco: Results from a large-scale national survey

People with spinal cord injury in Morocco: results from the very first systematic data collection

PURPOSE

To report on the methodology, participant characteristics, and associations of four most frequent environmental barriers with health conditions, general health and quality of life (QoL) in the very first systematic data collection in people with spinal cord injury (SCI) in Morocco.

MATERIALS AND METHODS

We obtained data from 385 participants of the cross-sectional Moroccan SCI community survey (MorSCI). We used descriptive statistics to describe participant characteristics and regression models to investigate associations of the five most frequently reported environmental barriers with health conditions (secondary conditions, pain intensity, mental health), general health and QoL.

RESULTS

The most frequently reported environmental barriers were "lack of public services" (92.5%), "financial strain" (93.0%), restricted access to "public transportation" (85.5%), "public places" (83.9%) and "private places" (84.7%). People who perceived those factors as barriers also reported more secondary conditions, higher pain intensity, lower mental health, lower general health, and lower QoL.

CONCLUSIONS

This study on Moroccans with SCI found that environmental barriers detract from health and QoL. Given that environmental barriers are potentially modifiable, policy interventions present powerful tools to reduce barriers and potentially increase health and QoL in this vulnerable population.IMPLICATIONS FOR REHABILITATIONPublic policy on the construction of transportation and public places is important to make the physical environment accessible for wheelchair users to support their participation in society.The provision of adequate rehabilitation services and specialized post-acute rehabilitation units for people with SCI in Morocco is urgently needed, not only to contribute to health and QoL but also to contribute to their abilities to overcome environmental barriers.Adequate state services including universal health coverage and access to rehabilitation services and assistive devices or adapted tools must be a priority on the policy level to facilitate activities of daily living and reduce barriers.Improving the skills and knowledge of health professionals in SCI rehabilitation and guide policy makers to promote patient education and self-advocacy in the meantime, may help reduce the gap between needs of people with SCI and available support.

A Demographic Profile of Disability Assessed Patients in Selected Tertiary Care Hospitals in Coastal Karnataka, India: A Retrospective Study

Background

Disability assessment is a critical component in getting a comprehensive and amicable compensation in medico-legal cases. The data regarding acquired disability among the hospital-admitted patients are lacking. The purpose of this study was to determine the demographic profile of disability-assessed patients in tertiary care hospitals in Coastal Karnataka, India between 2010 and 2019. The study also aims to evaluate the pitfalls in the present assessment method.

Materials and Methods

A record-based retrospective study of all the cases assessed by the investigator in tertiary care hospitals in Coastal Karnataka between 2010 and 2019 was analyzed. The disability was assessed using Govt. of India guidelines. Data were analyzed using descriptive statistics.

Results

A total of 2004 cases were analyzed; among them, 85% were males. The average percentage of disability was 26% (SD = 16.2). Mean age of the patients was 38 years, the median calculated for duration of hospital stay was 15 days, and 15% patients had multiple disabilities. The Brachial plexus injury resulted in the highest percentage of disability (76%) followed by spine (43%) and head injury (38%). Locomotor disability was found in 77% of cases, and lower limbs and right side were involved twice more than the upper limbs and left side.

Conclusion

The study reveals the demographic profile of disability-assessed patients admitted in hospitals. This database will help to create awareness among health care professionals, Govt. bodies, and insurance companies about the magnitude of the problem.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43465-022-00706-4.

Association of visual impairment with disability: a population-based study

OBJECTIVE

To determine the relationship between visual impairment and other disabilities in a developing country.

METHODS

In this cross-sectional ancillary study, all individuals 50 years and older in 18 communities in the Chitwan region of Nepal were administered visual acuity screening and the Washington Group Short Set (WGSS) of questions on disability. The WGSS elicits a 4-level response for six disability domains: vision, hearing, walking/climbing, memory/concentration, washing/dressing, and communication. The association between visual impairment and disability was assessed with age- and sex-adjusted logistic regression models.

RESULTS

Overall, 4719 of 4726 individuals successfully completed visual acuity and disability screening. Median age of participants was 61 years (interquartile range: 55-69 years), and 2449 (51.9%) were female. Participants with vision worse than 6/60 in the better-seeing eye were significantly more likely to be classified as having a disability in vision (OR 18.4, 95% CI 9.9-33.5), walking (OR 5.3, 95% CI 2.9-9.1), washing (OR 9.4, 95% CI 4.0-21.1), and communication (OR 5.0, 95% CI 1.7-13.0), but not in hearing (OR 0.6, 95% CI 0.006-2.2) or memory (OR 2.2, 95% CI 0.7-5.1).

CONCLUSIONS

Visually impaired participants were more likely to self-report disabilities, though causality could not be ascertained. Public health programs designed to reduce visual impairment could use the WGSS to determine unintended benefits of their interventions.

Correlation between functional disability and quality of life among rural elderly in Anhui province, China: a cross-sectional study

Objective

We aimed to explore the correlation between functional disability and quality of life (QoL). And exploring the interaction of functional disability, basic demographic characteristics and health-related information on QoL among the rural elderly in Anhui Province.

Methods

This study used multi-stage stratified cluster sampling in rural Anhui Province from January to July 2018 to conduct a cross-sectional survey of older adults who met the inclusion criteria. The Five-Dimensional European Quality Of Health Scale (EQ-5D) and the WHO Disability Assessment Schedule (WHODAS2.0) scale were used to evaluate the QoL and functional disability, and the basic demographic characteristics of the survey subjects were also collected. Using binary logistic and Classification and regression tree model (CART) models to analyze the data, explore the relationship between functional disability and QoL in the elderly.

Results

A total of 3491 older adults were included in the survey, and 3336 completed the entire survey, with an effective response rate of 95.56%. After adjusting for covariables, those who had limited in dimension of mobility (AOR=2.243, 95%CI: 1.743-2.885), getting along (AOR=1.615, 95%CI: 1.173-2.226), life activities (AOR=2.494, 95%CI:1.928-3.226), and social participation (AOR=2.218, 95%CI: 1.656-2.971) had a lower QoL. However, the dimension of cognition (AOR=0.477, 95%CI: 0.372-0.613) is a protective factor for QoL. Additionally, we also observe that 96.3% of those who were unemployed and limited in both mobility and life activities dimensions had a lower QoL, but among those who were robust in both mobility and social participation dimensions and not suffer from chronic diseases, 56.3% had a higher QoL.

Conclusions

Our findings indicate that special attention should be paid to the elderly who are unemployed, have limited in cognition, getting along, social participation, mobility, life activities and cognition robust to improve their QoL. This research is of great significance for formulating targeted strategies and measures to improve the QoL for rural elderly.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12363-7.

Association between functional disability and depressive symptoms among older adults in rural China: a cross-sectional study

Objectives

The aim of this study was to explore the relationship between functional disability and depressive symptoms, focusing on whether an interaction exists between functional disability, demographic characteristics and depressive symptoms among older adults in rural China.

Design

A cross-sectional study using multistage, stratified random sampling.

Setting

Data from 18 villages in Anhui Province of China between January to July 2018.

Participants

3491 Chinese participants aged 60 and over.

Primary and secondary outcome measures

The 30-item Geriatric Depression Scale and WHO Disability Assessment Schedule 2.0 were used to evaluate depressive symptoms and functional disability, respectively. Data were analysed using SPSS statistics V.25.0 program with χ2 test, Mann-Whitney U test, binary logistic regression analysis and classification and regression tree (CART) model.

Results

The prevalence of depressive symptoms in 3336 interviewed older people was 52.94%. After adjustment, subjects who had problems in mobility domain (adjusted OR (AOR) 1.842, 95% CI 1.503 to 2.258), getting along domain (AOR 1.616, 95% CI 1.299 to 2.010), life activities domain (AOR 1.683, 95% CI 1.370 to 2.066) and participation domain (AOR 3.499, 95% CI 2.385 to 4.987) had an increased depressive symptoms risk. However, cognition domain (AOR 0.785, 95% CI 0.647 to 0.953) negatively correlated with depressive symptoms. Additionally, the CART model showed that those who had problems in mobility domain, getting along domain and were unemployed, the possibility of having depressive symptoms was the highest.

Conclusions

More attention should be paid to unemployed older adults, and those with problems in participation, life activities, getting along and mobility and no problems in cognition to maintain a good psychological state.

Spinal cord injury in the Moroccan healthcare system: A country case study

In this article, the authors report an overview of the healthcare management of People with Spinal Cord Injury living in Morocco. The authors' experience in monitoring neurologic recovery and rehabilitation expectations and outcomes are also presented. In addition to the epidemiological data, the patient journey through the chain of care, living with Spinal Cord Injury, the health and rehabilitation system are discussed. This paper illustrates well the suffering of people with Spinal Cord Injury specifically and of disabled persons in general living in low and middle-income countries, especially with the lack of access to specialized and quality rehabilitation facilities and shortage of healthcare workers specialized in rehabilitation.